What is IVF?
In vitro fertilization (IVF) is a term that describes a number of techniques that can be used to help people that are struggling to conceive. Having previously worked as an Embryologist in one of the UK's largest IVF clinics, today I'm honored to be sharing my knowledge about IVF with you. Read on to learn all about IVF from what it stands for to the process itself, success rates, and more….
Here we will outline the general processes and themes that you can expect along the way should you undergo IVF. However, if you have any specific questions or concerns about your own fertility, it’s always a good idea to talk to your healthcare professional to learn more.
What does IVF stand for?
IVF stands for in vitro fertilization. In vitro is Latin for 'within the glass', meaning it happens outside the body. The process of IVF involves taking a female cell egg and fertilizing it with a male sperm cell in the laboratory. This process can be performed using a couple’s own eggs and sperm or donated eggs and sperm.
The IVF process step by step
Before we go any further, it's important to recognize that everyone's IVF journey is different. The experience will vary depending on your unique medical history, and can also be influenced by the results during the treatment process itself. Healthcare professionals differ in their preferred treatments, and therefore not everyone's experience will be the same.
When I was working in the clinic, I often used to advise patients not to compare their results (for example, their AMH levels or number of eggs collected) to others. Averages published by regulatory bodies are useful to give patients context, but each journey really is unique. You have to remember that it only takes one sperm and one egg to result in a healthy baby!
Referral and fertility investigations - for most people on this journey, the first step towards getting treatment is when you are referred to a fertility clinic or specialist after trying to conceive for a period of time without getting pregnant. (This period is often around 12 months, but this can be less depending on age or medical history.) At this point, the fertility clinic will perform a series of initial fertility investigations for both the male and female partners, such as checking the health of your partner’s semen or ruling out any conditions. Depending on the outcome, you may be recommended IVF or another alternative.
Suppressing your natural cycle- if you make the decision to go forward with IVF, the menstrual cycle must be suspended using special drugs. This helps healthcare professionals monitor and control the cycle during different phases of the treatment.
Ovary stimulation- drugs are used that cause the ovaries to start producing egg cells. Naturally, ovaries usually only produce one egg at a time, however, when stimulated with drugs the aim is for them to produce more.
Monitoring and egg maturation- next, ultrasound scans are used to observe the development of the eggs within the ovaries. The amount of drugs used to stimulate your ovaries may be increased or decreased depending on the development of follicles (sacs that contain eggs) within the ovaries. Another drug is then given to help them mature.
Egg retrieval- this timed procedure is performed by a healthcare professional where a needle is inserted through the vagina and into the ovaries to remove the eggs. It’s common to be sedated for this part of the procedure.
Sperm preparation- the male partner or donor can produce a fresh sperm sample on the same day of the egg collection for preparation. They can also provide frozen samples.
Fertilizing the eggs- eggs are either mixed with sperm or sometimes sperm are injected into the eggs instead in a process called ICSI (Intracytoplasmic Sperm Injection). This is performed for a number of reasons including low sperm quality or if there is a risk that fertilization will not happen by simply placing the sperm and eggs together.
Fertilization call- a healthcare professional should call you after the egg retrieval to inform you of the number of eggs that were fertilized by the sperm cells. The number of fertilized eggs is likely to be less than the number collected as not all eggs will fertilize.
Growing the embryos- embryos are grown in incubators in the laboratory for a number of days. The length of time again depends on the clinic, and your clinical history however, the routine length of time is five days.
Transferring the embryos- embryos are graded and transferred back into your womb. This is a quick procedure, taking around 10 minutes that does not usually require sedation. A special catheter (very thin tube) is inserted into the uterus through the cervix, the embryo is delivered and the catheter is removed.
Pregnancy test- this is performed two weeks after the transfer. While it may be tempting to take a test earlier, the test is more accurate 14 days or more after the transfer. This is because after this time the implanted embryo begins to release the hormone used in pregnancy detection.
IVF success rates
When looking at which clinic to visit, some choose one that is closest to home for convenience and others consider the success rates of clinics. Success rates vary from clinic to clinic and they also vary in the method of presentation of their results. Remember no two fertility journeys are the same, but as a guideline, here are the success rates by age group taken from the Human Fertilisation and Embryo Authority in the UK.
- 32% for women under 35
- 25% for women aged 35-37
- 19% for women aged 38-39
- 11% for women aged 40-42
- 5% for women aged 43-44
- 4% for women over 44
Making the choice to try IVF is not a light decision and we understand it can be both physically and emotionally taxing. You may choose to seek support from counselors before, during and after the process.
On top of weighing up the challenges of the process, there are also a number of health risks it’s good to be aware of, including:
- Side effects from drugs used during IVF include headaches and hot flashes
- Multiple births such as twins or triplets - these come with their own risks
- Ectopic pregnancy- the embryo implants in the fallopian tubes rather than the uterus
- Ovarian hyperstimulation syndrome (OHSS) - this happens when the ovaries overreact to the drugs administered to stimulate egg growth
How much does IVF cost?
Cost is a huge consideration in IVF. Some governing bodies provide it for free or at a reduced cost, but this is very dependent upon the area where you live, often within the country you live. The cost also varies depending on your medical history. In many cases, if you or your partner already have biological children, you may not be eligible for free IVF treatment.
In the United States, you can expect to pay around $12,000 plus the cost of medications for a single round of IVF. Insurance providers differ on coverage depending on the state you live in but more information can be found here.
In the UK, it costs around £5,000 per cycle. You can also consider getting treatment abroad, but it’s important that you investigate the clinic's regulation levels to ensure they are meeting licensed treatment standards.
Is IVF for me?
IVF is such a personal journey. Some keep it private, others like to inform those around them. Some worry significantly about the outcome of each step, while others are able to take each moment as it comes. I believe IVF can be for anyone, you can just tailor your experience depending on how you feel at the time. If you know that you worry more than most, talking to those around you and asking for their support on the phone or in person throughout your journey might help.
You can also pre-book professional help with a therapist or counselor so you start the process prepared. Some couples plan their treatment in advance and collectively decide to commit to only 3 cycles for example. This can be helpful for keeping perspective. Some continue to work around the treatments, others decide to take time off. It really is up to you. Healthcare professionals are also there to support you emotionally and physically before, during, and after your treatment.
All fertility journeys are important
Assisted reproductive technologies (ART) is the name given to a number of fertility treatments, one of which is IVF. But there are more which can be used to help those become parents from all walks of life. You may be single, in a same-sex relationship, or having sex to conceive may not be an option for you.
Donor insemination- involves putting sperm inside the vagina of the person wanting to get pregnant. This can be performed at home, with sperm from a licensed fertility clinic, a sperm bank or someone that you know. If the sperm is not from a licensed fertility clinic, the person donating can be tested for sexually transmitted infections beforehand.
IUI (Intrauterine insemination)- this is when the sperm from a donor or partner is put into the womb of the person wanting to get pregnant. It's different from donor insemination because often the semen is prepared in a laboratory so that the sperm are concentrated and then placed into the womb. IUI has lower success rates compared to IVF but it is less invasive and therefore can be tried before moving on to IVF. It's also cheaper than IVF per attempt.
Surrogacy- this is when someone with a uterus has a baby for people who cannot or choose not to get pregnant themselves. Eggs can come from a donor or from the surrogate themselves.
Adoption and fostering- this is an option for those who do not want to use assisted reproductive technologies to have a child. The application process tends to be long and requires disclosing in-depth details about the individuals applying.
Get to know your fertile window
Thanks for reading up on IVF. We know the uncertainty that comes with starting a family can make it a stressful time. At Natural Cycles we’re proud to offer a non-hormonal birth control that can also help you conceive. In fact, our recent study showed that women who use Natural Cycles to plan pregnancy get pregnant in three cycles or less. Natural Cycles is an FDA cleared medical device that also works with irregular cycles. Why not find out if it’s right for you today?
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